A Point-of-Care Testing for Anaemia in Children Using Portable Haematocrit Meter Pilot Study from Southwest Nigeria and Implications for Developing Countries

Abstract

BACKGROUND: Prompt and accurate diagnosis is needed to prevent the untoward effects of anaemiaon children. Although haematology analyzers are the gold standard for accurate measurement ofhaemoglobin or haematocrit for anaemia diagnosis, they are often out of the reach of most healthfacilities in resource-poor settings thus creating a care gap. We conducted this study to examine theagreement between a point-of-care device and haematology analyzer in determining the haematocritlevels in children and to determine its usefulness in diagnosing anaemia in resource-poor settings.METHODS: EDTA blood samples collected from participants were processed to estimate theirhaematocrits using the two devices (Mindray BC-3600 haematology analyzer and Portable MissionHb/Haemotocrit testing system). A pairwise t-test was used to compare the haematocrit (PCV) resultsfrom the automated haematology analyzer and the portable haematocrit meter. The agreement betweenthe two sets of measurements was assessed using the Bland and Altman method where the mean,standard deviation and limit of agreement of paired results were calculated.RESULTS: The intraclass and concordance correlation coefficients were 0.966 and 0.936. Sensitivityand specificity were 97.85% and 94.51% respectively while the positive predictive and negative predictivevalues were 94.79% and 97.73%. The Bland and Altman`s limit of agreement was -5.5 ̶ 5.1 with themean difference being -0.20 and a non-ignificant variability between the two measurements (p = 0.506).CONCLUSION: Haematocrit determined by the portable testing system is comparable to that determinedby the haematology analyzer. We therefore recommend its use as a point-of-care device for determininghaematocrit in resource-poor settings where haematology analyzers are not available.